المؤلفون: Baik, Minyoul¹ (AUTHOR), Jeon, Jimin¹ (AUTHOR), Heo, Seok-jae² (AUTHOR), Yoo, Joonsang¹ (AUTHOR), Kim, Jinkwon¹ (AUTHOR) antithrombus@gmail.com

المصدر: International Journal of Stroke. Mar2024, Vol. 19 Issue 3, p359-366. 8p.

مصطلحات موضوعية: *INTRACRANIAL aneurysms, *TREATMENT duration, *ISCHEMIC stroke, *COHORT analysis, *REGRESSION analysis

مصطلحات جغرافية: SOUTH Korea

مستخلص: Background: Stent-assisted coil (SAC) is increasingly used to treat unruptured intracranial aneurysm (UIA). However, the optimal duration of dual-antiplatelet therapy (DAPT) after SAC insertion remains unknown. Aim: To assess the time-dependent effect of DAPT on the risk of ischemic and hemorrhagic complications after SAC. Methods: This is a retrospective cohort study among patients with UIA treated with SAC using the nationwide health claims database in South Korea between 2009 and 2020. Multivariate Cox regression analysis was used, which included the use of DAPT as a time-dependent variable. The effect of DAPT was investigated for each period of "within 90 days," "91 to 180 days," "181 to 365 days," and "366 to 730 days" after SAC. The primary outcome was a composite of ischemic stroke and major bleeding in each period within two years after SAC. Results: Of the 15,918 patients, mean age at SAC was 57.6 ± 10.8 years, and 3815 (24.0%) were men. The proportion of patients on DAPT was 79.4% at 90 days, 58.3% at 180 days, and 28.9% at 1 year after SAC. During the 2 years after SAC, the primary composite outcome occurred in 356 patients (2.2%). DAPT significantly reduced the primary composite outcome within 90 days after SAC (adjusted hazard ratio (aHR), 0.44; 95% confidence interval (CI), 0.28–0.69; p < 0.001); however, this was not the case after 90 days (all p > 0.05). DAPT reduced ischemic stroke risk within 90 days (aHR, 0.31; 95% CI 0.18–0.54; p < 0.001), and 91 to 180 days after SAC (aHR 0.40; 95% CI 0.18–0.88; p = 0.022); however, after 180 days, DAPT was no longer beneficial. Conclusions: In patients with UIA treated with SAC, 3 months of DAPT was associated with a decreased risk of the composite of ischemic and hemorrhagic complications. [ABSTRACT FROM AUTHOR]

المؤلفون: Choi, Hyun Ho¹ (AUTHOR), Jang, Doeun^2,3 (AUTHOR), Na, Hyuntak^2,3,4 (AUTHOR), Hong, Noah⁵ (AUTHOR), Lee, Sung Ho⁶ (AUTHOR), Kim, Kang Min⁶ (AUTHOR), Kang, Hyun-Seung⁶ (AUTHOR), Kim, Jeong Eun⁶ (AUTHOR), Shin, Aesun^2,3,4 (AUTHOR), Cho, Won-Sang⁶ (AUTHOR)

المصدر: Cerebrovascular Diseases. Dec2023, Vol. 52 Issue 6, p624-633. 10p.

مصطلحات موضوعية: *INTRACRANIAL hemorrhage, *FIBRINOLYTIC agents, *ANTICOAGULANTS, *NATIONAL health insurance, *SMOKING

مصطلحات جغرافية: SOUTH Korea

مستخلص: Introduction: Concerns about spontaneous intracranial hemorrhages (sICHs) have increased over time with the increasing use of antithrombotic agents. Hence, we aimed to analyze the risk and risk fractions for antithrombotics in sICHs in South Korea. Methods: From the National Health Insurance Service-National Sample Cohort including 1,108,369 citizens, 4,385 cases, aged 20 years or more and newly diagnosed as sICHs between 2003 and 2015, were included in this study. A total of 65,775 sICH-free controls were randomly selected at a ratio of 1:15 from individuals with the same birth year and sex according to a nested case-control study design. Results: Although the incidence rate of sICHs started to decrease from 2007 onward, the use of antiplatelets, anticoagulants, and statins continued to increase. Antiplatelets (adjusted odds ratio [OR] 3.59, 95% confidence interval [CI] 3.18–4.05), anticoagulants (adjusted OR 7.46, 95% CI 4.92–11.32), and statins (adjusted OR 1.98, 95% CI 1.79–2.18) were significant risk factors for sICHs even after adjusting for hypertension, alcohol intake, and cigarette smoking. From 2003–2008 to 2009–2015, the population-attributable fractions changed from 28.0% to 31.3% for hypertension, from 2.0% to 3.2% for antiplatelets, and from 0.5% to 0.9% for anticoagulants. Conclusion: Antithrombotic agents are significant risk factors for sICHs, and their contribution is increasing over time in Korea. These findings are expected to draw the attention of clinicians to precautions to be taken when prescribing antithrombotic agents. [ABSTRACT FROM AUTHOR]

المؤلفون: Park, Hyeree^1,2,3 (AUTHOR), Cho, Sun Wook⁴ (AUTHOR) nsdrcho@gmail.com, Lee, Sung Ho⁵ (AUTHOR), Kim, Kangmin⁵ (AUTHOR), Kang, Hyun-Seung⁵ (AUTHOR), Kim, Jeong Eun⁵ (AUTHOR), Shin, Aesun^1,2,3 (AUTHOR) shinaesun@snu.ac.kr, Cho, Won-Sang⁵ (AUTHOR) nsdrcho@gmail.com

المصدر: Thyroid. Dec2023, Vol. 33 Issue 12, p1483-1490. 8p.

مصطلحات موضوعية: *THYROID diseases, *INTRACRANIAL aneurysms, *NATIONAL health insurance, *CASE-control method, *SMOKING, *HYPERTHYROIDISM

مصطلحات جغرافية: SOUTH Korea

مستخلص: Background: Few risk factors for the development of intracranial aneurysms (IAs) are known. We investigated the potential role of thyroid diseases in IA development using nationwide real-world data. Methods: A nested case–control study within the National Health Insurance Service—National Sample Cohort data from 2002 to 2019 was performed. A total of 5335 patients with unruptured IA were matched by age and sex with 80,025 controls at a ratio of 1:15. We estimated the odds ratios (ORs) and corresponding confidence intervals [CIs] between thyroid diseases and unruptured IA using a multivariable conditional logistic regression model. Results: Tobacco smoking, use of antihypertensive medication, and hypothyroidism were significantly associated with an elevated risk for unruptured IA in univariate analysis. In multivariable analysis, a history of hypothyroidism was associated with unruptured IA (adjusted OR: 1.46 [CI: 1.26–1.69]). Among patients with hypothyroidism, long-term use of thyroid hormone for >5 years was associated with a reduced risk for unruptured IA (adjusted OR: 0.69 [CI: 0.48–0.99]). A history of hyperthyroidism was associated with a reduced risk for unruptured IAs (adjusted OR: 0.71 [CI: 0.54–0.93]). In secondary analyses of the data according to sex, the respective observed associations between hypothyroidism and hyperthyroidism and the risk of IAs were found to be statistically significant in females but not in males. Conclusions: Hypothyroidism is associated with an increased risk of unruptured IAs, whereas hyperthyroidism is associated with a reduced risk. Overall, the findings suggest that thyroid hormones may play a protective role in the development of unruptured IAs. Further studies are needed to clarify potential direct causality and the biologic mechanisms relating thyroid dysfunction and unruptured IA. [ABSTRACT FROM AUTHOR]

المؤلفون: Kim, Tackeun^1,2,3 (AUTHOR), Choi, Jisu¹ (AUTHOR), Park, Won-Ju⁴ (AUTHOR), Cho, Seunghyeon⁴ (AUTHOR), Yoo, Yeongjae⁴ (AUTHOR), Kim, Hyeonjun⁴ (AUTHOR), Cho, Juhee⁵ (AUTHOR), Joo, Jin-Deok^1,5,6 (AUTHOR) etude9@gmail.com, Oh, Chang Wan^2,3 (AUTHOR) wanoh@snu.ac.kr

المصدر: Scientific Reports. 11/20/2023, Vol. 13 Issue 1, p1-8. 8p.

مصطلحات موضوعية: *INTRACRANIAL aneurysms, *DISEASE risk factors, *MEDICAL screening, *PERIODIC health examinations, *CEREBROVASCULAR disease, *ODDS ratio, *MACHINE learning

مصطلحات جغرافية: SOUTH Korea

مستخلص: Intracranial aneurysm (IA) is difficult to detect, and most patients remain undiagnosed, as screening tests have potential risks and high costs. Thus, it is important to develop risk assessment system for efficient and safe screening strategy. Through previously published research, we have developed a prediction model for the incidence risk of IA using cohort observational data. This study was designed to verify whether such a prediction model also demonstrates sufficient clinical performance in predicting the prevalence risk at the point of health screening, using cross-sectional data. The study population comprised individuals who visited the Chonnam National University Hwasun Hospital Health Promotion Center in Korea for voluntary medical checkups between 2007 and 2019. All participants had no history of cerebrovascular disease and underwent brain CTA for screening purpose. Presence of IA was evaluated by two specialized radiologists. The risk score was calculated using the previously developed AI model, and 0 point represents the lowest risk and 100 point represents the highest risk. To compare the prevalence according to the risk, age-sex standardization using national database was performed. A study collected data from 5942 health examinations, including brain CTA data, with participants ranging from 20 to 87 years old and a mean age of 52 years. The age-sex standardized prevalence of IA was 3.20%. The prevalence in each risk group was 0.18% (lowest risk, 0–19), 2.12% (lower risk, 20–39), 2.37% (mid-risk, 40–59), 4.00% (higher risk, 60–79), and 6.44% (highest risk, 80–100). The odds ratio between the lowest and highest risk groups was 38.50. The adjusted proportions of IA patients in the higher and highest risk groups were 26.7% and 44.5%, respectively. The median risk scores among IA patients and normal participants were 74 and 54, respectively. The optimal cut-off risk score was 60.5 with an area under the curve of 0.70. We have confirmed that the incidence risk prediction model built through machine learning also shows viable clinical performance in predicting prevalence risk. By utilizing this prediction system, we can effectively predict not only the incidence risk but also the prevalence risk, which is the probability of already having the disease, using health screening data. This may enable us to consider strategies for the early detection of intracranial aneurysms. [ABSTRACT FROM AUTHOR]

المؤلفون: Bong-Gyu Ryu¹, Si Un Lee¹ nsmidget@gmail.com, Hwan Seok Shim¹, Jeong-Mee Park¹, Yong Jae Lee¹, Young-Deok Kim¹, Tackeun Kim¹, Seung Pil Ban¹, Hyoung Soo Byoun², Jae Seung Bang¹, O-Ki Kwon¹, Chang Wan Oh¹

المصدر: Journal of Korean Neurosurgical Society. Nov2023, Vol. 66 Issue 6, p690-702. 13p.

مصطلحات موضوعية: *HOSPITAL size, *INTRACRANIAL aneurysms, *THERAPEUTIC embolization, *NATIONAL health insurance, *CEREBRAL infarction

مصطلحات جغرافية: SOUTH Korea

مستخلص: Objective : To analyze the outcomes of coil embolization (CE) for unruptured intracranial aneurysm (UIA) according to region and hospital size based on National Health Insurance Service data in South Korea. Methods : The incidence of complications, including intracranial hemorrhage (ICRH) and cerebral infarction (CI), occurring within 3 months and the 1-year mortality rates in UIA patients who underwent CE in 2018 were analyzed. Hospitals were classified as tertiary referral general hospitals (TRGHs), general hospitals (GHs) or semigeneral hospitals (sGHs) according to their size, and the administrative districts of South Korea were divided into 15 regions. Results : In 2018, 8425 (TRGHs, 4438; GHs, 3617; sGHs, 370) CEs were performed for UIAs. Complications occurred in 5.69% of patients seen at TRGHs, 13.48% at GHs, and 20.45% at sGHs. The complication rate in TRGHs was significantly lower than that in GHs (p=0.039) or sGHs (p=0.005), and that in GHs was significantly lower than that in sGHs (p=0.030). The mortality rates in TRGHs, GHs, and sGHs were 0.81%, 2.16%, and 3.92%, respectively, with no significant difference. Despite no significant difference in the mortality rates, the complication rate significantly increased as the number of CE procedures per hospital decreased (p=0.001; rho=-0.635). Among the hospitals where more than 30 CEs were performed for UIAs, the incidence of CIs (p=0.096, rho=-0.205) and the mortality rates (3 months, p=0.048, rho=-0.243; 1 year, p=0.009, rho=-0.315) significantly decreased as the number of CEs that were performed increased and no significant difference in the incidence of post-CE ICRH was observed. Conclusion : The complication rate in patients who underwent CE for UIA increased as the hospital size and physicians' experience in conducting CEs decreased. We recommend nationwide quality control policies CEs for UIAs. [ABSTRACT FROM AUTHOR]

المؤلفون: Cho, Kyung-Hee, Baek, Seol-Hee, Kim, Sung-Hee, Kim, Byung-Su, Sohn, Jong-Hee, Chu, Min Kyung, Kang, Mi-Kyoung, Mo, Hee Jung, Lee, Sang-Hwa, Park, Hong-Kyun, Cho, Soohyun, Oh, Sun-Young, Seo, Jong-Geun, Lee, Wonwoo, Lee, Ju-Young, Lee, Mi Ji, Cho, Soo-Jin

المصدر: Journal of Headache & Pain; 6/25/2024, Vol. 25 Issue 1, p1-9, 9p

مصطلحات موضوعية: STATISTICAL significance, RESEARCH funding, INTRACRANIAL hypertension, HEADACHE, TREATMENT effectiveness, RETROSPECTIVE studies, DESCRIPTIVE statistics, LONGITUDINAL method, MEDICAL records, ACQUISITION of data, RESEARCH, DATA analysis software, MIGRAINE

مصطلحات جغرافية: SOUTH Korea

مستخلص: Background: Currently, there is a relative lack of detailed reports regarding clinical presentation and outcome of idiopathic intracranial hypertension in Asians. This study aims to describe the clinical features and treatment outcomes of Korean patients with idiopathic intracranial hypertension. Methods: We prospectively recruited patients with idiopathic intracranial hypertension from one hospital and retrospectively analyzed the medical records of 11 hospitals in Korea. We collected data regarding preceding medical conditions or suspected medication exposure, headache phenotypes, other associated symptoms, detailed neuroimaging findings, treatments, and outcomes after 1–2 and 3–6 months of treatment. Results: Fifty-nine (83.1% women) patients were included. The mean body mass index was 29.11 (standard deviation, 5.87) kg/m²; only 27 patients (45.8%) had a body mass index of ≥ 30 kg/m². Fifty-one (86.4%) patients experienced headaches, patterns of which included chronic migraine (15/51 [29.4%]), episodic migraine (8/51 [15.7%]), probable migraine (4/51 [7.8%]), chronic tension-type headache (3/51 [5.9%]), episodic tension-type headache (2/51 [3.9%]), probable tension-type headache (2/51 [3.9%]), and unclassified (17/51 [33.3%]). Medication overuse headache was diagnosed in 4/51 (7.8%) patients. After 3–6 months of treatment, the intracranial pressure normalized in 8/32 (25.0%), improved in 17/32 (53.1%), no changed in 7/32 (21.9%), and worsened in none. Over the same period, headaches remitted or significantly improved by more than 50% in 24/39 patients (61.5%), improved less than 50% in 9/39 (23.1%), and persisted or worsened in 6/39 (15.4%) patients. Conclusion: Our findings suggest that the features of Asian patients with idiopathic intracranial hypertension may be atypical (i.e., less likely obese, less female predominance). A wide spectrum of headache phenotypes was observed. Medical treatment resulted in overall favorable short-term outcomes; however, the headaches did not improve in a small proportion of patients. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Headache & Pain is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Sung Min Lim, Eunji Go, Jungsup Lee, Go Eun Lee, Eun Joo Kim, Chihyoung Son

المصدر: Journal of Acupuncture & Meridian Studies; Dec2023, Vol. 16 Issue 6, p248-254, 7p

مصطلحات موضوعية: RESEARCH, STATISTICS, WRIST joint, REHABILITATION centers, MUSCLE relaxants, CLINICAL trials, ELBOW joint, PHYSICAL therapy, ANALGESICS, ONE-way analysis of variance, INTRACRANIAL hemorrhage, CEREBRAL infarction, TREATMENT duration, ARM, SPASTICITY, TREATMENT effectiveness, PRE-tests & post-tests, OCCUPATIONAL therapy, STROKE patients, QUALITY of life, ELECTRIC stimulation, DESCRIPTIVE statistics, REPEATED measures design, RESEARCH funding, DATA analysis software, DATA analysis, ELECTROACUPUNCTURE, LONGITUDINAL method

مصطلحات جغرافية: SOUTH Korea

مستخلص: Background: Post-stroke upper limb spasticity (PS-ULS) causes a decline in the quality of life of patients by reducing their ability to perform normal daily activities. Objectives: We performed pre- and post-treatment analyses of the changes in stroke patients with ULS following constant electroacupuncture therapy (EAT). Methods: Thirty patients with PS-ULS underwent 12 sessions of EAT over 4 weeks. After performing acupuncture therapy at four acupoints on the affected arm (LI11, LI10, LI4, and TE5), electrostimulation (60 Hz) was performed for 20 min. The modified Ashworth scale (MAS) and the Fugl-Meyer assessment of the upper extremity (FMA-UE) were measured as the outcome variables. Results: Following EAT, there was a significant decrease in the elbow MAS score (p < 0.001), a significant decrease in the wrist MAS score (p < 0.01), and a significant increase in the FMA-UE score (p < 0.001). Adverse events related to EAT were not reported. Conclusion: EAT decreased upper limb spasticity and improved functional recovery at the elbow and wrist. Large-scale and rigorous clinical trials are needed to verify the efficacy of EAT. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Acupuncture & Meridian Studies is the property of Medical Association of Pharmacopuncture Institute (MAPI) and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Jun Seok Koh, Gyojun Hwang, Jung Cheol Park, Chang-Young Lee, Joonho Chung, Sang-Weon Lee, Hyon-Jo Kwon, Seong-Rim Kim, Dong-Hun Kang, Soon Chan Kwon, Sung-Tae Kim, Chul Hoon Chang, Dong-Kyu Jang, Jae Hyung Choi, Young Woo Kim, Bum-Tae Kim, Byoung Gook Shin, Seung Hoon You, Seung Young Chung, Junkyeung Ko

المصدر: Journal of NeuroInterventional Surgery; Nov2023, Vol. 15 Issue 11, p1095-1104, 10p

مصطلحات موضوعية: MEDICINE, CLINICAL trials, SURGICAL stents, PLASTIC surgery, TREATMENT effectiveness, CLOPIDOGREL, PLATELET aggregation inhibitors, RESEARCH funding, DESCRIPTIVE statistics, ASPIRIN, THROMBOEMBOLISM, LOGISTIC regression analysis, INTRACRANIAL aneurysms, PATIENT safety

مصطلحات جغرافية: SOUTH Korea

مستخلص: Background Antiplatelet therapy, where regimens are tailored based on platelet function testing, has been introduced into neurointerventional surgery. This nationwide registry study evaluated the effect and safety of tailored antiplatelet therapy in stent assisted coiling for unruptured aneurysms compared with conventional therapy using a standard regimen. Methods This study enrolled 1686 patients in 44 participating centers who received stent assisted coiling for unruptured aneurysms between January 1, 2019 and December 31, 2019. The standard regimen (aspirin and clopidogrel) was used for all patients in the conventional group (924, 19 centers). The regimen was selected based on platelet function testing (standard regimen for clopidogrel responders; adding cilostazol or replacing clopidogrel with other thienopyridines (ticlopidine, prasugrel, or ticagrelor) for clopidogrel non-responders) in the tailored group (762, 25 centers). The primary outcome was thromboembolic events. Secondary outcomes were bleeding and poor outcomes (increase in modified Rankin Scale score). Outcomes within 30 days after coiling were compared using logistic regression analysis. Results The thromboembolic event rate was lower in the tailored group than in the conventional group (30/762 (3.9%) vs 63/924 (6.8%), adjusted OR 0.560, 95% CI 0.359 to 0.875, P=0.001). The bleeding event rate was not different between the study groups (62/762 (8.1%) vs 73/924 (7.9%), adjusted OR 0.790, 95% CI 0.469 to 1.331, P=0.376). Poor outcomes were less frequent in the tailored group (12/762 (1.6%) vs 34 (3.7%), adjusted OR 0.252, 95% CI 0.112 to 0.568, P=0.001). Conclusion Tailored antiplatelet therapy in stent assisted coiling for unruptured aneurysms reduced thromboembolic events and poor outcomes without increasing bleeding. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of NeuroInterventional Surgery is the property of BMJ Publishing Group and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Youngheon Lee, Jung Hwan Lee, Hyuk Jin Choi, Byung Chul Kim, Seunghan Yu, Mahnjeong Ha

المصدر: Journal of Korean Neurosurgical Society; Sep2023, Vol. 66 Issue 5, p543-551, 9p

مصطلحات موضوعية: BRAIN injuries, PATIENT monitoring, INTRACRANIAL pressure, NERVOUS system injuries, GLASGOW Coma Scale

مصطلحات جغرافية: SOUTH Korea

مستخلص: Objective: This study aimed to investigate the current status of intracranial pressure (ICP) monitoring in patients with severe traumatic brain injury (sTBI) in Korea and the association between ICP monitoring and prognosis. In addition, a survey was administered to Korean neurosurgeons to investigate the perception of ICP monitoring in patients with sTBI. Methods: This study used data from the second Korea Neurotrauma Databank. Among the enrolled patients with sTBI, the following available clinical data were analyzed in 912 patients: Glasgow coma scale score on admission, ICP monitoring, mortality, and extended Glasgow outcome scale score at 6 months. In addition, we administered a survey, entitled "current status and perception of ICP monitoring in Korean patients with sTBI" to 399 neurosurgeons who were interested in traumatic brain injury. Results: Among the 912 patients, 79 patients (8.7%) underwent ICP monitoring. The mortality and favorable outcome were compared between the groups with and without ICP monitoring, and no statistically significant results were found. Regarding the survey, there were 61 respondents. Among them, 70.4% of neurosurgeons responded negatively to performing ICP monitoring after craniectomy/craniotomy, while 96.7% of neurosurgeons responded negatively to performing ICP monitoring when craniectomy/craniotomy was not conducted. The reasons why ICP monitoring was not performed were investigated, and most respondents answered that there were no actual guidelines or experiences with post-operative ICP monitoring for craniectomy/craniotomy. However, in cases wherein craniectomy/craniotomy was not performed, most respondents answered that ICP monitoring was not helpful, as other signs were comparatively more important. Conclusion: The proportion of performing ICP monitoring in patients with sTBI was low in Korea. The outcome and mortality were compared between the patient groups with and without ICP monitoring, and no statistically significant differences were noted in prognosis between these groups. Further, the survey showed that ICP monitoring in patients with sTBI was somewhat negatively recognized in Korea. [ABSTRACT FROM AUTHOR]

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المؤلفون: Kim, Jinkwon^1,2 (AUTHOR), Kim, Jang Hoon³ (AUTHOR), Lee, Hye Sun⁴ (AUTHOR), Suh, Sang Hyun⁵ (AUTHOR) suhsh11@yuhs.ac, Lee, Kyung-Yul¹ (AUTHOR) suhsh11@yuhs.ac

المصدر: PLoS ONE. 5/27/2021, Vol. 16 Issue 5, p1-15. 15p.

مصطلحات موضوعية: *INTRACRANIAL aneurysms, *BLOOD pressure, *SYSTOLIC blood pressure, *HYPERTENSION, *BLOOD pressure measurement, *COHORT analysis

مصطلحات جغرافية: SOUTH Korea

مستخلص: Background: High blood pressure is a major risk factor for the development and rupture of cerebral aneurysm. Endovascular coil embolization and surgical clipping are established procedures to treat cerebral aneurysm. However, longitudinal data of blood pressure after the treatment of cerebral aneurysm and its impact on long-term prognosis are not well known. Methods: This retrospective cohort study included 1275 patients who underwent endovascular coil embolization (n = 558) or surgical clipping (n = 717) of cerebral aneurysm in 2002–2015 using the nationwide health screening database of Korea. Systolic and diastolic blood pressure of patients were repeatedly obtained from the nationwide health screening program. We performed a multivariate time-dependent Cox regression analysis of the primary composite outcome of stroke, myocardial infarction, and all-cause death. Results: During the mean follow-up period of 6.13 ± 3.41 years, 89 patients suffered the primary outcome. Among the total 3546 times of blood pressure measurement, uncontrolled high blood pressure (systolic ≥140 mmHg or diastolic ≥90 mmHg) was 22.9%. There was a significantly increased risk of primary outcome with high systolic (adjusted HR [95% CI] per 10 mmHg, 1.16 [1.01–1.35]) and diastolic (adjusted HR [95% CI] per 10 mmHg, 1.32 [1.06–1.64]) blood pressure. Conclusions: High blood pressure is prevalent even in patients who received treatment for cerebral aneurysm, which is significantly associated with poor outcome. Strict control of high blood pressure may further improve the prognosis of patients with cerebral aneurysm. [ABSTRACT FROM AUTHOR]